The obese child

▶ We are in the midst of an epidemic of obesity in which we have no effective treatment strategies ▶ Specialist clinics are required to meet demand and take the agenda forward, although this may be difficult to achieve given the lack of evidence for treatment ▶ Paediatricians have a clear role in identifying the rare cases where there is a medical cause, and in managing frank co-morbidity ▶ Issues are less clear when it comes to identifying comorbidities (which are extremely prevalent) ▶ The rate limiting step in mapping out best practice is the lack of effective treatment ▶ There is no justification for introducing screening until we have effective treatment, and more harm than good may be achieved by doing so.